重性抑郁障碍病人生活质量及其影响因素

摘要

目的 评估重性抑郁障碍(major depressive disorder,MDD)病人的生活质量,分析其影响因素.方法 对符合美国精神障碍诊断与统计手册第4版(Diagnostic and Statistical Manual of Mental Disorders 4th edition,DSM-IV)诊断的92例成人重性抑郁障碍病人及80例健康对照使用世界卫生组织生存质量测定量表简表(World Health Organization Quality of Life Scale Brief,WHOQOL-BREF)、汉密尔顿抑郁量表17项(the 17-item Hamilton Depression Rating Scale,HAMD-17)、汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)、社会支持量表(Social Support Rating Scale,SSRS)进行评估.结果 重性抑郁障碍病人的WHOQOL-BREF各维度评分均低于健康对照(P<0.05);对病人组进行Pearson相关分析显示,WHOQOL-BREF各维度评分与HAMD-17、HAMA评分呈负相关,与SSRS评分呈正相关(P<0.01).性别与WHOQOL-BREF的社会关系领域呈负相关(P<0.05),而病程与WHOQOL-BREF的环境领域呈负相关(P<0.05).对病人组进行逐步多元线性回归分析显示,HAMD-17评分与WHOQOL-BREF的生理、心理领域得分呈负相关(P<0.05);SSRS的主观支持评分与WHOQOL-BREF的心理、社会关系、环境领域呈正相关(P<0.05);SSRS中对支持的利用度、家庭收入等级与WHOQOL-BREF的心理领域也有影响(P<0.01).结论 重性抑郁障碍病人的生活质量低于一般人群,并且症状越重、病程越长及社会支持度越差，生活质量越差.而男性病人可能具有更差的生活质量.具有稳定的配偶也有助于提升生活质量.%Objective To evaluate the quality of life in patients with major depressive disorder and analyze the influencing factors.Methods A total of 92 adult patients with major depressive disorder (MDD) diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) and 80 healthy controls were evaluated using the World Health Organization Quality of Life Scale Brief (WHOQOL-BREF),the 17-item Hamilton Depression Rating Scale (HAMD-17),Hamilton anxiety scale (HAMA) and social support rating scale (SSRS) for evaluation.Results The WHOQOL-BREF dimensions scores of patients with major depressive disorder were lower than healthy controls (P<0.05);and significantly negatively correlated with HAMD-17,HAMA score;and SSRS scores were significantly correlated (P<0.01);Gender was negatively correlated with the social relationship in WHOQOL-BREF (P<0.05),while the duration was negatively correlated with the environmental areas in WHOQOL-BREF(P<0.05).Regression analysis found that HAMD-17 and physiological,psychological domain scores were negatively correlated (P<0.05).The factor of subjective score in SSRS and psychological,social relationship,environmental areas in WHOQOL-BREF were related (P<0.05);the use of the psychological field support was also affected (P<0.01).Conclusion The quality of life in patients with major depressive disorder was lower than the general population.More severe symptoms,longer durations and weaker social support,and male may result in poorer quality of life.A stable marriage helps to improve the quality of life.